Caring for Aging Parents Terms to Know and Understand
2025 was the year I learned more caring for aging parents terms than I ever knew existed. Over 7 months my husband and I experienced memory care, skilled nursing, long term care, palliative care, and hospice care with both my mom and his dad. Each of these types of care has a specific definition which is important to understand. Medicare pays or does not pay according to them. Your loved one also receives specific types of services under each definition.
I will let you in on what each of these caring for aging parents terms means below.
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Caring for Aging Parents Terms to Know and Understand
Both my mom and my husband’s dad’s care journeys began where most people’s do – in the hospital. The hospital is pretty easy to understand relative to the other types of care available for your loved one. The patient stays in the hospital and receives care prescribed by their medical team. Decisions will be affected by Medicare and other insurance coverages. And at some point your parent will have to leave the hospital -and it will be long before you think they are ready.
Once there is not a medical necessity for them to stay in the hospital, they will be discharged. With help from the medical team, you will need to figure out what type of care they are eligible for and if Medicare will pay for it. The best option if they are not ready to go home, is skilled nursing.
**I am not an attorney, a medical professional, or a representative of Medicare or any insurance. The following are my understandings in plain English of what we experienced. Laws and codes and rules change all of the time. I have included links to Medicare when appropriate.
Caring for Aging Parents Terms: Skilled Nursing
Who pays: Medicare pays for the days they approve after (currently) a $1,736 co-payment
To qualify for skilled nursing your parent must have spent 3 days in a row in the hospital. This has to be 3 INPATIENT days, and it does not include observation. Of course, there are always exceptions and appeals, but this is the standard.
Skilled nursing will take place at a skilled nursing facility or rehabilitation center. Skilled nursing is a step down from hospital care. It provides physical, occupational, and speech therapies and other skilled care that must be provided by a doctor or nurse like an IV.
Your parent will also receive meals and have their medications administered. Your parent CAN qualify for up to 100 days, but the criteria are strict and they will most likely be discharged long before that. They need to show a continuing need for therapy, along with continuing improvement that cannot be provided on an outpatient basis. My mom had cycled through skilled nursing twice before her final admission, and each time it was for 20 days. My father-in-law was given 2 separate admissions of 20 days as well.
The best part about skilled nursing is the care your parent will receive while you figure out a longer term plan, if they are not going to be able to go home. The tougher part for us was it is not the hospital.
Regulations state they may not restrain the patient in any way. Bed rails and bed alarms are not permitted. Both of our parents fell more than once during skilled nursing. You will be tempted to go cray-cray on the staff, but they are following the rules. And, they are not staffed well enough to always have someone with your parent. The best solution is to lower their bed almost to the ground and put down a fall mat. We also ended up hiring private sitters, which Medicare does not pay for.
Caring for Aging Parents Terms: Palliative Care
Who pays: Medicare pays 80% of medically necessary services and equipment.
My mom was given palliative care in the hospital. I had always thought this was another word for hospice care, but it is different. It is a service to manage pain, symptoms, and side effects of chronic illness. It does not mean the patient has discontinued curative treatment.
Caring for Aging Parents Terms: Memory Care
Who pays: The patient pays for 100% of the cost of memory care.
My father-in-law went to memory care after skilled nursing. It was a very nice facility, and we were grateful for their care. However, no matter how nice it is, it is still a tough place to be. He had a room with his own furniture and a private bath and they provided meals and activities for the residents, in addition to help with medications. The staff also helped with dressing, bathing, and the bathroom as time permitted. Any additional services like physical therapy were billed separately.
Memory care facilities are also not permitted to restrain your parent in any way. No bedrails or bed alarms. This was a problem, and my father-in-law eventually fell and broke his arm, so he ended up back in the hospital, then back in skilled nursing. Elder care is a bit of a not fun merry-go-round.
Caring for Aging Parents Terms: Long-Term Care
Who pays: The patient pays 100% of the cost. Private long-term care insurance is available.
After breaking his arm, my father-in-law no longer qualified for memory care, so we had to use long-term care. This is what most of us have called a “nursing home.” A long term care facility is also not permitted to use fall preventing restraints. This is the most frustrating aspect to any care-type except the hospital. “Studies show” the restraints don’t reduce falls. My question is “why do the hospitals use them, then?”
Even with a long-term care situation, we ended up hiring a sitter for the nights. We were considering other situations, but he did not survive long enough for us to pursue them. If you are going to have to hire help around the clock, in addition to the staff at the facility, it might be better to be at home. It depends on how active and “impulsive” your parent is. If they will not stay in their bed or wheelchair because they can’t remember they can’t walk, then you are in for a rough time at a long-term care facility.
Caring for Aging Parents Terms: Activities of Daily Living
Here is a fun one and it is part of the evaluation to determine if a patient is eligible for hospice care. The activities of daily living are bathing, continence, dressing, eating, toileting, and transferring.
Caring for Aging Parents Terms: Hospice
Who pays: Medicare pays for hospice, but ONLY hospice. It’s complicated.
A patients qualifies for hospice when it is determined they have a terminal illness and a life expectancy of 6 months or less. The patient must have stopped any treatments that are considered “curative.” Hospice is a blessing for the patient and family. My father-in-law was on hospice for several weeks. They came in and helped with some of his activities of daily living and the hospice medications were covered.
Here is the complicated part: Medicare pays for hospice services, but not room and board. The patient still has to cover the costs of the long-term-care facility and any care that is not “hospice.” My mom was in skilled nursing (covered by Medicare) when she began a rapid deterioration in her condition . We were asked if we wanted her to be transferred to the hospital via ambulance. We declined the transfer because we did not want her to have to go to the hospital and be poked and prodded one more time when it would not help.
We decided we would ask for hospice because the medical opinion was she was not going to last even 24 more hours and she was very uncomfortable. We wanted to ease her pain and agitation. Hospice arrived and began the medications to help. I was called into the hallway by a staff member who very gingerly explained to me that because my mom was now on hospice she did not qualify for skilled nursing anymore and we would have to pay for the room.
This is another time when you want to start yelling and accusing everyone within earshot of being heartless, but again, it is the rule. The staff member has no control over what is and is not paid for. I understood the “rules” because my father-in-law had been in long term care on hospice just 3 months prior. I knew that hospice was covered, but his room was not. I told her that was fine. We did not want her moved. She died less than 12 hours after that conversation and hauling her around in an ambulance and starting an iv and all of that would not have helped. It just would have made her and the rest of us miserable.
It was a tough 7 months for us and I know if you are reading this you are probably in the middle of the care of an aging parent or are anticipating it. My heart is with you. When you are going through it, it feels like you are the only one experiencing it or who has experienced it. I wanted to share these terms with you and let you know you are not alone.
I am not any kind of expert. I am just sharing my understanding of what we learned and saw during the care of our parents. Do not rely on any of this information as an official explanation of anything. I pray for your comfort and peace while you care for your loved one. God bless you and yours.
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